Postpartum hair loss

Hormonal changes during pregnancy, specifically an increase in oestrogen levels, extend the anagen (active) growth phase. A lot of women say their hair has never been thicker or fuller during pregnancy, exactly for this reason. A rapid drop in oestrogen after birth pushes a large proportion of follicles into the shedding phase simultaneously⁴. Once hormone levels stabilise, hair typically recovers, though the timeline varies.

Female Pattern Hair Loss (FPHL)

FPHL has historically been linked to a shift in the balance between oestrogen and androgens (such as testosterone). This shift becomes more pronounced during perimenopause and menopause, as oestrogen declines, and in conditions like Polycystic ovarian syndrome (PCOS), recently renamed Polyendocrine metabolic ovarian syndrome (PMOS), where androgen excess is a defining feature. Outside of PMOS, the androgen link is far from straightforward. A significant proportion of women with FPHL show no signs of relative androgen excess at all, and anti-androgen treatments have produced inconsistent results in clinical trials, which challenges the idea that androgens are the sole driver¹. Oestrogen appears to play a protective role, prolonging the active growth phase of the hair cycle, and its natural decline during perimenopause and menopause correlates with gradual, ongoing hair loss¹. 

Thyroid dysfunction

The thyroid gland produces thyroid hormones that regulate the metabolic rate of nearly every cell in the body, including those in the hair follicle. Both underactive (hypothyroid) and overactive (hyperthyroid) states can disrupt the hair growth cycle, causing loss and thinning⁵. In these cases, follicles are pushed into the shedding phase prematurely, causing diffuse thinning across the scalp. These states can be driven by autoimmune conditions such as Hashimoto's disease, the leading cause of hypothyroidism, or Graves' disease, the leading cause of hyperthyroidism⁸ ⁹. Because thyroid-related hair loss typically improves once thyroid function is diagnosed and managed, testing with your GP is the essential first step.

Genetics affects your hair in two distinct ways. It can drive a hair loss pattern directly, or it can shape how strongly you respond to other triggers.

Female pattern hair loss (FPHL)

Genetics may influence hair loss most significantly in FPHL, although the picture is more complex and less clearly understood than in male pattern baldness. While FPHL shares some features with its male counterpart, research suggests the underlying mechanisms are not identical. The genetic predisposition to patterned hair loss is thought to act partly through the androgen receptor, which governs how the follicle responds to androgens such as DHT. The link is well established in men. In women it appears to contribute in some cases, but the evidence is weaker, and as mentioned earlier, FPHL can develop even without raised androgen levels. Current evidence suggests that multiple genes may contribute rather than a single inherited factor, and genome-wide studies specific to FPHL remain limited compared with the body of research on male pattern hair loss¹.

Inherited susceptibility

Shedding triggered by stress, illness, or nutritional deficiency follows a physiological pathway rather than a genetic one. However, your genetic makeup can influence how susceptible you are to those triggers. Variations in genes controlling nutrient absorption, hormone metabolism, and stress response mean that two women experiencing the same trigger may shed at very different rates. Your genes determine how sensitive you are; the trigger simply sets it off.

Daily habits shape your hair over time. By changing the input or removing the trigger, in most cases the follicle recovers and growth resumes. 

Stress

A physical or emotional shock, illness, surgery, or a major life event can push a large share of follicles from active growth into the resting phase at once. This type of hair loss is known as Telogen Effluvium (TE), and the resulting hair fall is usually observed 2 to 3 months after the event⁶. Managing nervous system regulation, sleep, recovery and cortisol load supports a return to your usual growth and shedding patterns.  

Tension and styling 

Tight ponytails, slick backs, extensions, braids, and weaves pull at the follicle day after day. That constant tension weakens the anchor at the root and, over time, can cause traction alopecia, a type of thinning that typically starts at the hairline and temples. Acting on traction loss early reverses loss and sees growth resume. Prolonged tension can scar the follicle, and the loss may become permanent. Loosening tension at the root and giving your hair and scalp ‘recovery days off’ can prevent or reverse this type of hair loss. 

Heat and chemical stress

Repeated heat styling, bleaching and chemical straightening damage the hair shaft rather than the follicle. The result feels like loss because strands snap mid-length and density drops. This is breakage, not shedding, and will recover with lower heat, heat protection, and spacing out chemical treatments. 

Female Pattern Hair Loss (FPHL)

While FPHL is driven by genetics and hormonal sensitivity at the follicle, lifestyle choices can influence the speed or compound the appearance of the increased shedding.

Insufficient intake

Nutritional deficiency is one of the most common triggers for hair loss, and one of the most overlooked. Micronutrients are major elements which drive the hair growth cycle, playing a role in cellular turnover in the rapidly dividing matrix cells of the follicle bulb². This constant division depends on a steady nutrient supply. When levels fall short, the body prioritises vital organs first. Hair is non-essential for survival, so the follicle sits at the back of the queue. That's why deficiency shows up as thinning and shedding, and why normal growth responds so well once the gap is addressed. 

Keratin, the protein that forms the main structure of your hair, is built from the amino acids in dietary protein. When intake falls short, keratin production is limited, and hair grows weaker, structurally compromised and more prone to breakage. Iron, zinc, vitamin D, biotin, and B vitamins including biotin have all been implicated in hair loss when chronically low², and restrictive or rapid-weight-loss (crash) diets are often cited as a trigger. Micronutrient deficiencies in key vitamins and minerals are a modifiable risk factor for hair loss, with evidence that correcting these deficiencies can support hair follicle health and treatment outcomes². 

Female Pattern Hair Loss (FPHL)

Emerging research suggests that nutritional status may influence the progression of FPHL. A study by Piccini et al. found that affected and miniaturised follicles in FPHL display relative nutritional deficiency and a dormant metabolic state, though their capacity to absorb nutrients remains intact³. It indicates that while supplementation will not reverse the underlying genetic drivers of FPHL, it may support follicle function and represents a credible adjunctive approach.

Your scalp is the soil your hair grows from, and no follicle thrives in depleted soil. 

A dry, tight scalp signals a compromised barrier. When the scalp loses moisture and its protective lipid layer thins, it becomes reactive, flaky and inflamed. Low-grade inflammation can disrupt your follicle’s ability to hold and grow healthy hair strands. The reverse problem of excess oil can be just as disruptive. When sebum is over-produced, it builds up around the follicle, trapping dead skin and debris and creating conditions for irritation that can weaken the hair’s anchor. 

Your scalp also hosts a living microbiome, a community of microorganisms that, when in balance, keeps the surface stable. When that ecosystem is thrown off by harsh cleansing, product buildup, or over-washing, opportunistic yeasts and bacteria multiply. The result is itching, flaking, and irritation that can interrupt the growth cycle and increase shedding or breakage. 

As covered in the stress section, a significant illness, high fever, or major surgery can trigger Telogen Effluvium, with shedding appearing two to three months after the triggering event⁶. 

Certain medications carry hair loss as a documented side effect; if you have concerns about a medication you're taking, your prescribing doctor is the best point of contact. GLP-1 medications, now widely used for weight management, are a recent example. While more research is needed to confirm the link between their use and hair loss⁷, if a Telogen Effluvium response is experienced due to the associated drop in nutrient intake, it is typically temporary and responds once nutritional support is restored. Prioritising nutrient-dense, protein-rich foods during weight loss can help protect against this.

Alopecia areata

Alopecia areata is an autoimmune condition where the immune system attacks the hair follicle, pushing it into a resting state and causing sudden, patchy loss. There's usually a genetic predisposition behind it, and stress can trigger a flare, though it won't cause the condition. See a GP or dermatologist for assessment. Apotecari supports overall hair and scalp health; it isn't a treatment for autoimmune hair loss.

The upside
Topical delivery direct to the scalp. The right formulation can extend the active growth phase, reduce shedding and support density at the follicle. Easy to access.

The reality
Not all serums are created equally. Active ingredients, clinical research and penetration rates vary widely, so you’ll need to be discerning. Look for clinically proven actives, scientific efficacy data, and delivery technology that drives active ingredients below the surface.

The upside
Can address the root cause from the inside. Non-invasive and easy to access. Can support regrowth, blood flow and reduced shedding, while supporting your wellbeing more broadly. Useful across life stages, including postpartum.

The reality
Requires consistency to see results. Not all supplements are created equally, so ingredient quality, dosing and formulation require scrutiny. 

The upside
Blocks DHT, a key driver of hair loss in males with an established scientific research base. 

The reality
Rarely prescribed for women, and unsuitable during pregnancy. Since the link between DHT and FPHL is less finite, Finasteride is rarely a first-line option. Prescription only. When used in women, it requires specialist supervision. 

The upside
Widely available and researched in women. Can support regrowth by improving blood flow to the follicle.

The reality
Requires consistent daily use, and results reverse if you stop. May cause scalp irritation or dryness.

The upside
Visible results relatively quickly.

The reality
Invasive, painful and expensive, with extended recovery. Less suited to female pattern loss,  which can have a more diffuse pattern than its male counterpart. Ongoing treatment is still required, since follicles can continue to miniaturise over time in women with Female Pattern Hair Loss. 

The upside
Can support blood flow and density.

The reality
High cost and a real time commitment. The evidence base is still emerging.